10 SUTTON AVE - BUILDING INSPECTION (8) The Commonwealth of Massachusetts RECEI�r 17
e��.y Board of Building Regulations and Standards 1. �t-
I 'hT� Massachusetts State Building Code, 780 CNIR iIa"?F n � SALENI
Ty-
r l�eyisp�ilJji 7011
W Building Permit Application To Construct, Repair, Renovate Or %� jotSjl a2 hp t[
® One- or Two-Family Dwelling L v
This Section For Official JJse Only
Building Permit Number: Date plied:
i Building Official(Print Name) .Signature -Date
SECTION 1: SITE INFORMATION
1.1,yeVddr,Rsse L2 Assessors Nlap& Parcel Numbers
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: LA Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
L6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Cl Private❑ Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
A �� Co+g �c�_teM MA-ot9-7G
Name(Print) City,State,ZIP
I n S.,_-V6 . Rt.2 q7S 7YS-72-'77
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) M' Addition ❑
Demolition ❑ Accessory Bldg ❑ Number of Units_ Other ❑ Specify:
Briet_Description of Proposed Work': QY
5 t d¢ [moo .e
r e r J e
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: _
(Labor and Materials) Official Use Only
L Building $ S-- I. Building Permit Fee: $ Indicate how fee is determined:
�. Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
J. Plumbing S 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees:$
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ �S OoO ❑ Paid in Full ❑ Outstanding Balance Due:
MIL l��z1l-&::,
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
_ GS-r�(s& S�lr9�i�
t .fit Y' S 2� License Number Expiration Date
Name of CSL Holder '
/S No/�"h 5� List CSL Type(see below) (,i
No. and Street Type Description
� AlL� �..7� U Unrestricted(Buildings u to 35.000 cu. ft.)
� I
ct R Restricted 1&2 Family Dwelling
City/Town, State,ZIP NI Mason
ry RC Roofing Covering
WS Window and Siding
C, SF Solid Fuel Burning Appliances
( -a- I Insulation
Telephone Email address D Demolition
5.2'nn Registered Home Improvement Contractor(HIC) 1,01
D 1 &C 9 ?_
h+j-- Al {/di c&,y �K G - HIC Registration Number E�xpi°rat`i'on Date
FIIC Compan Name or I-IIC Registrant Name
No nd Street
�a a`nn n^ O lq� G Email address
City/Town, State,ZIPI l r l Telephone
SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152. § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes .......... 12/' No ........... ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, as Owner of the subject property, hereby authorize C A L E S 10✓2
to act on my behalf, in all matters relative to work authorized by this building perrdit application.
(o }yam{ OCT 2 7 2015
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
Bye ring my name below, I hereby attest under the pains and penalties of perjury that all of the information
cont ' d this application is true and accurate to the best of my knowledge and understanding.
rT 'OCT 2 7 2015
Print Owner's or Authorized gene's Name(Electronic Signature) Date
NOTES:
L An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dos
2. When substantial work is planned, provide the information below:
Total Floor area(sq. ft.) (including garage, finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information / Please Print Legibly
/
Name(Business/Orgmization/Individual): p"r's{ �Y� (�S In C,
Address: I (—,;-
City/State/Zip: C
Fama
employer?Check the appropriate box: Type of project(required):
employer with�_ 4. ❑ I am a general contractor and I 6. ❑New construction
yees(full and/or part-time)." have hired the sub-contractors
sole proprietor or partner- listed on the attached sheet.t 7. �Renrodeling
d have no employees These sub-contractors have S. ❑Demolition
g for me in any capacity. workers'comp.insurance. g, ❑Building addition
rkers'comp,insurance 5. ❑ We are a corporation and its
d.] officers have exercised their 10.❑Electrical repairs or additions
3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs
insurance required.]t employees.[No workers'
comn.insurance required.] 13.❑Other
Any applicant that checks box#t must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidavit indicating such.
'Contractors that check this box most attached an additional sheet showing the name of the sub-contractors and their workers'court.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins,Lic.#: o p—q3/� g ( � Expiration Date:1-1 ,y��� o
Job Site Address:—0—su kl 1�(/-e— City/State/Zip:_Sca-e t't /P t �"0 1 /7U
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a£me
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby werhftJ!!4nitter ep s and penalties ofperjury that the information provided above is true and correct
Si ature: _ Date n 9n7
Phone
FOfficial only. Do not write in this area,to be completed by city or town official
n: Permit/License#
hority(circle one):
Health 2.Building Department 3.City/1'own Clerk 4.Electrical Inspector 5.Plumbing Inspector
son: Phone#:
Certificate No: A044298
> THE COMMONWEALTH OF MASSACHUSETTS
1 EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPNIEI T
DEPARTMENT OF LABOR STANDARDS
19 STANIFORD STREET, BOSTON,MASSACHUSETTS 02I I4 i
DELEADER CONTRACTOR LICENSE
A &A SERVICES, INC.
115 NORTH STREET
i
SALEM MA 01970
i
LICENSE: DC000440 EXPIRES: Saturday,June 25,2016 �
IN ACCORDANCE WITH M.G.L. CH. 111, § 197B(b)AND 454 CMR 22.03,THIS LICENSE IS ISSUED BY
THE DEPARTMENT OF LABOR STANDARDS TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF
ENTERING INTO OR ENGAGING IN DELEADING WORK.
i
I
i
THIS LICENSE IS VALID FOR A PERIOD OF ONE YEAR.
i
i
I '
THIS LICENSE MUST BE MAINTAINED BY THE CONTRACTOR WHEN ENGAGED IN DELEADING
WORK IN ACCORDANCE WITH M.G.L. CH. I 1 I § 197B(b)(2)AND 454 CMR 22.03.
I
i
YY l
WILLIAM D.McKINNEv,DIRECTOR
Massachusetts Department of Public Safety
Office of Consumer Affairs&Business Regulation Board of Building Regulations and Standards
a k—--,'HOME IMPROVEMENT CONTRACTOR `- """' ' ° """
1 `�iRegistration: 101609 Type: I License: CS-0577, I
,Expiration: 6/26/2016 Private Corporatiol tr
1 CBMSTOPHER-Z4)
PIE 4&A SERVICES, INC Y/f 115 NORTH ST = 9 ¢ �s
i e Salem MA 019707
Christopher Zorzy j
115 North Street
Expiration
Salem, MA 01970 Undersecretary y �-
I Commissioner 05/26/2017
I
iA&A SERVICES, INC.
115 NORTH STREET
!SALEM, MA 01970
i �
vj��j/� A & A SERVICES, INC. 1p� V�
AQ!/1 S 115 NORTH STREET, SALEM, MA 01970
wrim,ion To •- Telephone:(978) 741-0424 Fax: (978) 74)-2012
Contractor Registration No. 101609
Construction Supervisor No.CS057733
Federal EIN: 04-3090162
MISCELLANEOUS SPECIFICATION SHEET
Buyers,
u er s Name Date of Contract
ten/ /d
Sol
Street Adtlress, Cit Sate antl Zi Code
S e N64_ G
Da imQe Tele hone�N/umber Evenin9 Telephone Number Mobile Telephone Number E-Mail Address
The Buyers)listed above hereby jointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on
this Specification sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification
Sheet is a pad.
SPECIAL INSTRUCTIONS
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It is agreed and understood by and between the parties that this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes
the entire understanding between the parties, and there are no verbal understandings changing or modifying any of the terms. This contract may not be changed or its
terms modified or vaned In any way unless such changes are in writing and signed by both the Buyers)and the Contractor.Buyeris)hereby acknowledge that Buyeris)
has read this Specification Sheet. /y
Contractor Initials: S �!) 9 � J L— Date: / Buyer's Initials: Date: iD r/-
r
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^ w0' A & A SERVICES, INC. 201
UA 115 NORTH STREET, SALEM, MA 01970
BrIM NO,M.Telyrd TO rd R 0 Telephone:(978) 741-0424 Fax: (978) 741-2012
Contractor Registration No. 101609
Construction Supervisor No.CS057733
Federal EIN: 04-3090162
MISCELLANEOUS SPECIFICATION SHEET
Bu er s Name Date of Conrad
e 2Co v d hAl ld /3—
Bu ers Street Atltlress. Gi ,State antl Zi Code
Da in Tale hone Number Evening Telephone Number Mobile Telephone Number E-Mail Address
ws�—
The Buyers)listed above hereby jointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on
this Specification sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification
Sheet is a pan.
SPECIAL INSTRUCTIONS
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mis agreed and understand by and between the parties that this Specification Sheet,along w in CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes
e entire understanding between the peace,and there are no verbal understandings changing or modifying any of the terms. This contract may not be changed or its
terms modified or varied in any way unless such changes are in writing and signed by both the pal and the Contractor.Buyers)hereby acknowledge that Buyer(s)
has read this Specification Sheet,
Contractor Initials: Date: (� i>� �S Buyer's Initials: >ti Date
/�� ,^, /�� �+ �^�C�c� A & A SERVICES, INC.
A&A SERVICES 115 NORTH STREET, SALEM, MA 01970
• -• Telophime:(978) 741-0424 Fax: (978) 741-2012
Contractor Registration No. 101609
Construction Supervisor No.CS057733
Federal EIN: 04-3090162
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT
Buys
u r s Name tt Date of Cc act
Bu ors Street Atldress, Cit State and Zip Code
O G
oa lose Teleprous Number Evening Telephone Number Mobile Telephone Number E-Mail Address
78 S-7
The Buyers)listed above hereby jointly and severally agree to purchase the goods and/or services listed on the accompanying specification sheets,in accordance
with the prices and terms described on the front and the reverse of this agreement and any specification sheets(this'Agreement"),and Buyers)have requested
that such goods or services be installed or provided atat Buyer's address listed above.ASA Services,Inc('Contractof),hereby agrees to install or cause to be installed
the products or services fisted in this Agreement at the Buyerls)address written above.This Agreement represents a cash sale of goods and Services,The Buyeds)
agree to pay in cash the cost of the goods and services purchased as described herein,regardless of timing or approval of any financing Buyerls)may seek for their
purchase. e�U p /
Purchase Pricer > /3S Est.Starting Date: IVO
�) I
Down Payment: `'' W _/'1 3 +AJ�!m Est CompletionDate- /9QUa'
El:Cash
Amount Due on Staff of Jab: - �L Q'.Check
��
Amount Due on_of Completion J.(J Ell Credit CardNo.
Amount Due on_of Completion: Expiration Date:
Balance Due on Upon Completion � Cited Code:
It is agreed and understood by and between the parties that this Agreement, front and back and any addendum, constitute the entire
understanding between the parties, and there are no verbal understandings changing or modifying any of the terms of this Agreement.Butterfat
hereby acknowledge that Buyerls)has read the front and the reverse of this agreement and has received a completed,signed and dated copy of this
Agreement,including the two attached Notice of Cancellation forms,on the date first written above.Buyerls)also(i)acknowledge that they were orally
informed of their right to cancel this transaction;and fill request that they be contacted via their telephone numbers or email,as listed above,in the event
Contractor believes Buyerfs)would be Interested in any additional quality products or services of Contractor.DO NOT SIGN THIS CONTRACT IF IT
CONTAINS ANY BLANK SPACES.
A&A Services,Inc. Buyer(s)By
Signs are
N / Li y Signet re
Print Name L
Print Name
Signature
Print Name
You,the Buyerls), may cancel this transaction at any time prior to midnight of the third business day after the date of this
transaction. See the following Notice of Cancellation form for an explanation of this right.
ARBRRATION:The eonlraMranethe homeowner nereey muwelly agree in aevence lnat In the ev teiNer pony nos a do,subrvnreming in.conmad.ennnptdy^er subunit turn ciumn.oa
p oss.arGnaeon teMce xfiicn nos teen approved by the Seaetaryol be Execulrelfire O of Gresu Affairs and Business Reguldons and the other paM Nall be required tosudrvt to and,atGiraeon as provedln M.G L c,10]A. C
DateCedrmnn lair.
J GaN t Init J
IOTICE OFCAI CELLATION b'OT CE OF CANCELLAT ON
Oats d Transactlon rYdu may enrol Nis irenwction eimom any penelry or Oate of Transaction Q on .Yw may cancel this iransatlim,vnNout any penaM1y or
mostalon,vA hen three .tin.sdaytlem Neepenedate,lr you ran¢I,any property tradedin, oeggeZed whin Nree bu tlayc hem ineaWve Bate.ll you carted,
anv paroranN mate br anearna Commnm sale.and any neaddable mawlmma.eduu:e a^v pmcemo-adm m.
by you roll era rewmea wmin 10 ears milbwnq receipt br Na senor or rom ranaenalon mote, e y payeadrea made ev v der the eo anal or sale and any negotiable mswmema.eormd
and err t hasty mlarem admoe out snow mid,midon wn a cancelled.u ^you roll be reamed Wind 10 days leisured
reamm br Na saner of re,rancewnon noire,
red harred,you men and any aewmy ,mmrest adding ml o1 me tantarddn mu be sanralmd.a ym cenral rmr mum
,reds avalhNe m me sailer at your maidens..and wbslanlally In as quad rdadon as.een mare availabse to be saner at your re deree,and tubmadddh in as goes cnndwon ss weed
derstured,any graded delivered to you under this contrast or sale:or you mi ffyce wan chat schaved,any goads delivered 0 im under this Conrad or Sale:d,may.m you»ten.comedy
froth the InsWmade of Me Seller mismasg the return shopmem of be goods at the Seller's with be irehourons of by Seller regarding Ne rerun Professor of the .a at the Salle,%
expenu and risk.11 yW do trade be goods available to the Seller and the SNIn ddos not etch expense and disk.11 you do make the goods available to the Sella'and fee South does me pad,.
them up either 20 days d are date of year Notion of eancellaion,you tray retain or meoose of the them up MNln 20 days of are data N your Notice d eancellalm.you may retain or dispose of
goods vnthout any further obllgalon.n you had to make the goods avoidable b be Sella,.or X you the goods vithout any further otegation.If yw fail mask^be goods turbines to be seller or or
:area to return are sows hebeSeiler and fall 0 do so.then you remain liable for pero,m+nse of you a,—hareem be goods t^NeSellerand fail to do so.Nest you retrein hm.for pedomance
all obligations underiho caned,To canoo has bansactlon,mail or deliver a signed and dated of all oMigadms under Ne London.To WnWIday da^sallon,mal or deliver asignee.and dafee.
mpy of the renrellandn nod®a am Omer wdfmn,dime,or and a Ielag,am.a o a rv,CeS, raw or the ranrelmdon noire or an oNer wale^rode.or tam a lelegam, qy'
115 Noah Street.Salem MA 01970,N0T LATER THANMIDNIGHTOF O r be NOMemeet,Salem MA 019]0,NOT LATER THAN MIDNIGHT OF 4
I NE0.FBY CANCEL THE TgAX5AR10N
1
XEREBY CANCEL THIS TRAN54CTION )�.e
\. Carsumer's sandeare Data ` +
Consorter s Signature - Oat
1 :4.YA k'4
ADDITIONAL TERMS AND CONDITIONS
Contractor Responsibility.The Contractor will issue its formal warranty upon full payment,which shall constitute the
Contractor's warranty for the labor and materials provided to the Buyer.Contractor agrees that all work done pursuant
to this contract shall be of a workmanlike manner using professional quality materials and supplies.Warranties are
available for inspection at the time of signing of the contract.Contractor accepts no responsibility for any damage
resulting from structural or other defects in the property at which the installation is carried out.Buyer acknowledges
Contractor's products do not correct or cure structural problems.Contractor shall not be responsible for(a)any
damages arising in whole or in part from strikes,fires,accidents,floods,governmental actions or any other causes
beyond control of Contractor or(b)any damages including without limitation,lost profits or reduction in value of Buyer's
property,arising from Contractor's delay in performing under this Agreement or due to its breach of this Agreement.
Condensation/Mold:The contractor is not responsible for conditions beyond its control,such as condensation which
may form on or within..a window or between windows resulting from pre-existing conditions in the Buyers home and,
external temperatures.Some condensation may also form on the frame or portions of the roof.Reducing the humidity in
your home will often remedy any condensation problems.The Contractor is also not responsible for existing or
developing spore or mold growth.Mold may be due to condensation which may form on or within walls or other surfaces
resulting from[pre-existing conditions in the Buyer's home and internal or external temperatures.Buyer indemnifies and
holds Contractor and its employees,authorized contractors and their subcontractors from any claims as to the
identification,detection,abatement,encapsulation or removal of mold,asbestos,lead based products or other
hazardous substances inside or outside of the structure being improved.
Permits:In Massachusetts,the Contractor is responsible for applying for and obtaining any and all necessary
permitting.Homeowners who secure their own permits will be excluded from the guaranty fund provisions of
Massachusetts law.
Delay/Unknown Conditions: Events beyond the control of the Contractor,such as Acts of God,labor strikes,
inclement weather,material shortages,Buyer's inability to quality or obtain financing,delays by local government
authorities in issuing or otherwise approving inspections,permitting or other required authorizations for the job,or other
events resulting in delays in performance of this agreement do not constitute abandonment and are not included in
calculating time frames for performance by Contractor.In the event the Contractor determines that this Agreement
cannot be performed as intended by the parties due,for example,to incorrect pricing,unforeseen structural defects or
pre-existing conditions to the Buyers property,the Contractor may cancel this Agreement within 30 days of its
execution,notify the Buyer of such a cancellation in writing and return all monies paid by the Buyer.The Contractor and
the Buyer(s)have determined that a definite completion date is not of the essence to this Agreement.Contractor will not
be responsible for any work not specifically listed in this Agreement or the Addendum.
Late Cancellation,Late Payment/Default: If Buyer attempts to cancel this Agreement at any time subsequent to
midnight of the third business day after the date of the Agreement,as more fully described on the Notice of Right to
Cancel form,and Contractor accepts such late cancellation,then Buyer agrees to pay Contractor a cancellation fee
equal to(i)15%of the Agreement's purchase price to offset Contractor's incurred labor,administrative fees and
material costs;plus(ii)the Contractor's costs for any specialty orders or any custom manufactured items.Buyer agrees
to pay 1 '/1%per month on all amounts due and owing from the buyer to the Contractor accruing from the date due and
running to the date the payment is made.If Buyer is in default of this Agreement,Buyer agrees to pay Contractor's
attorney fees equal to 15%of the defaulted amount or as otherwise allowed by applicable law.Buyer also agrees to pay
any other costs or expenses of repossession,collection,or realization on any security including court costs,to the
extent not prohibited by law.
Security Interest:This contract may result in a lien on or security interest on your residence.Buyer grants Contractor a
security interest under the Uniform Commercial Code and other applicable law governing security interests in the
property purchased pursuant to this Agreement,including a security interest in any proceeds from the sale of such
property.Buyer agrees that the property purchased under this Agreement is,and will remain,personal property,
regardless of the fact that said personal property may become attached to Buyer's real property.
No Set-Offs or Retentions.Upon substantial completion of the Contractors performance,Buyer shall pay all amounts
due under this Agreement in accordance with its terms without any right of set-off or retention.Substantial completion is
defined as the job being materially completed,functional as intended,and a final inspection,permit or occupancy
certificate,as the case may be,having been obtained.If after making full payment,the Buyer alleges that the work is
defective in any respect,the Contractor,without waiving any of its rights,shall cause an inspection of the premises and
perform any remedial work to the extent the Buyer is entitled thereto under this Agreement or the Contractors warranty
at no cost to the Buyer.
Buyer's Representations: Buyer represents and warrants that(a)any credit information furnished by Buyer in
connection with this transaction is true and complete;(b)no person has promised or offered to pay,credit,or allow to
Buyer any compensation or reward for the procurement of an Agreement with others as an inducement to enter into this
Agreement;(c)no person has offered,delivered,paid,credited,or allowed to Buyer any gift,bonus,award,money,
merchandise,trading stamps,or cash loan as an inducement to entering into this Agreement;(d)Buyer is the owner of
the property where the goods and services are being provided.
. Miscellaneous:Problems and inquiries can be directed to the Contractor,who may be reached at the telephone
number on the front of this Agreement:In construing this Agreement,the gender and number of words used may be
.,. changed to meet the context.Any part of this Agreement contrary to law of this State shall not invalidate other parts of
this Agreement.This Agreement is to be governed by the laws of the State in which it is performed.All contractors
and subcontractors must be registered by the administrator of the Massachusetts Board of Building
Regulations and Standards and any inquiries about a contractor or subcontractor relating to a registration
should be directed to the Director,Home Improvement Contractor Registration One Ashburton Place Room
1301,Boston,MA 02108 Tel:(617)727-8598.This Agreement and any accompanying documents represent the
entire agreement between the parties and there are no prior or contemporaneous oral or written agreements or
representations on which either parry is relying.Any modifications to this Agreement shall not be effective unless in
tZ ing(signed by the Buyer(s)and a President or Vice President of Contractor.The section headings contained in this
' Agreement are inserted for convenience only and shall not affect in any way the meaning or interpretation of this
Agreement,'
fiO< Phone: 978-741-0424
Fax 978-741-2012
es.comp & p SERVICE
115 North Street® s ® Salem, MA01970
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of M.G.L.c.40, Sec. 54, a condition of Building
Permit Number is that the debris resulting from this work shall be
disposed of in a property licensed facility as defined by M.G.L.c. 111, Sec. 150a.
The debris will be disposed at: Republic Services
320A Charger Street
Revere, MA 02150
or
Republic Services, Dumpster Service
at
115 North Street
Salem, MA 01970
&,j
Signature of Pe it Applicant
Christopher Zorzv, President
Name of Permit Applicant
OCT 2 7 2015
Date
A&A SERVICES,INC. - 2855
City of Salem 10/27/2015
Cote Porch Repair Permit 105.00
A&A Beverly Coop 6 Carpentry Repair Permit 105.00